It’s simply not true that vegans need to take handfuls of supplements to stay healthy, but we do all need to make sure we are getting enough vitamin B12
Vitamin B12 is made naturally by bacteria in the soil. Traditionally, people and animals would have obtained this vitamin by eating food from the ground. However, food production systems are now so sanitised and scrubbed clean that we do need to take a supplement.
Animals are no different to us and are not magical creators of vitamin B12. Meat, eggs and dairy foods contain it because farmed animals are given supplements too – their natural diet having been depleted in much the same way as our own. The argument to eat meat and dairy for B12 is therefore invalid — so why not get your B12 straight from the source?
B vitamins help our bodies release energy from the food we eat. Vitamin B12 also helps maintain healthy nerve cells and produces DNA — our genetic material. It works closely with folic acid to make red blood cells, which help iron to work better in our bodies. It also helps our immune systems to function normally and can even affect our mood.
Signs of deficiency include extreme tiredness, lack of energy, pins and needles, muscle weakness, depression and cognitive problems, such as impaired memory, understanding and judgement. Anaemia can occur when a lack of B12 or folate affects our body’s ability to produce enough red blood cells. A lack of B12 can also lead to a raised blood levels of an amino acid called homocysteine which, at high levels, is linked to heart disease.
We need only a little B12, and the government’s recommended intake is 1.5mcg a day (a microgram is a millionth of a gram), but getting that small amount is vital. US guidelines are slightly higher, at 2.4mcg, and the European Food Safety Authority suggest an ‘adequate intake’ of 4mcg a day.
Some studies suggest that vegans have lower B12 levels than people who eat meat and dairy, but many studies have only included B12 from food and ignored intake from supplements. The UK National Diet and Nutrition Surveys have found low vitamin B12 levels are not uncommon among the general population, regardless of diet, especially in people over 50. The reason is because absorption is a complicated process that declines with age. In order to absorb B12, it must first bind with a protein produced in the stomach called intrinsic factor. If you don’t make enough of this protein, you may not be able to absorb sufficient B12, even if your diet is awash with it.
Another reason absorption declines with age is because the amount of stomach acid we make can also drop as we get older. The B12 from meat is bound to animal protein so stomach acid is needed to release it before it can be absorbed. The B12 in fortified foods and supplements is not bound in this way and so is easier to absorb.
Absorption can also be reduced by poorly functioning kidneys, the diabetes drug Metformin and proton pump inhibitors, nitric oxide in cigarette smoke and nitrous oxide (NOS or laughing gas). In the US, all adults over 50 are advised to obtain their B12 from supplements or fortified foods because of the high numbers of people in this age group who have a reduced ability to absorb it from animal foods. Vegans have an advantage if they routinely include fortified foods and supplements in their diet.
Vitamin B12 is a water-soluble vitamin, so what you don’t need is excreted in your urine. Excessively high doses could be harmful but government guidelines say that taking up to 2,000mcg a day is unlikely to cause harm.
This vitamin can be lost in cooking, so heating B12-fortified plant milk in a microwave, for example, can destroy the B12 in a couple of minutes. On a hob or steaming, the milk would have to be at or near boiling point for five to seven minutes to destroy a significant amount. The best plant sources of B12 include yeast extract (Marmite/Vegemite) and B12-fortified foods such as nutritional yeast flakes, plant milks, vegan yoghurts and desserts, breakfast cereals and margarine. The body can store B12 for two to four years without being replenished so it can take a considerable time for any problems to develop after, say, changing your diet. Having said that, you should not rely on your body’s stores of B12.
Levels can be easily checked by a doctor and any deficiency can be treated with supplements or a course of injections. It’s important not to ignore your intake of B12 as by the time any symptoms develop, the damage may have already occurred.
Should you take a supplement? Yes. Viva!Health recommends fortified foods with a regular use of a supplement — particularly for children. This, and a well-planned and varied vegan diet, will meet your requirements and provide a healthier and safer source of vitamin B12 than obtaining it from animal products.
Fortified Food Guide
Micrograms of vitamin B12
(recommended amount = 1.5 micrograms per day)
4g serving (enough for one slice of toast)
5g serving (sprinkle on pasta, beans, etc)
1 tsp (5g serving)
Alpro Desserts & Yoghurts
Koko Dairy Free Yoghurt
Weetabix Oatbix Flakes*
Violife Chicken Slices
28g serving (2 slices)
One glass (250ml)
40g serving (2 slices)
*Many cereals fortified with B12 also contain vitamin D (D3) from lanolin, a substitute obtained from sheep’s wool. At the time of writing, Weetabix Weetaflakes and Oatibix Flakes contain B12 and no Vitamin D, so are suitable for vegans. This can change, and often does, so do read the ingredients list on the packet when you buy cereal.
Dr Justine Butler is Senior Researcher & Writer at Viva! Health